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DUPONT CIRCLE INC
RWIIR20002 District of Columbia Department of Health
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Covered Entity Details
Entity Name
District of Columbia Department of Health
Subdivision Name
HIV/AIDS, Hepatitis, STD & TB Administration
Type
Ryan White Part B ADAP Rebate Option
340B ID
RWIIR20002
Entity Address
2201 Shannon Place SE
Third Floor
334
WASHINGTON, DC 20020
Grant Number
X07HA00045
Participating Start Date
1/1/2011
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
DUPONT CIRCLE INC
Pharmacy Address
(DBA) DUPONT CIRCLE PHARMACY
1506 21ST ST NW STE 100
WASHINGTON, DC 20036-1017
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janis Jackson, Interim Chief of ADAP
(202) 671-4910
Contract Pharmacy Representative
Dupont Circle Pharmacy
ALFRED ADDICO, PRESIDENT
(202) 818-8070
Signed By Date
7/14/2023
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